zahra sheikhalipour

Professional autonomy is a crucial component of the nursing profession. It enables nurses to make timely decisions at the patient’s bedside. The competency of human resources, especially nurses, is essential in maintaining patient safety and ensuring high-quality services. This study investigates nurses’ professional autonomy and its association with patient safety competency.

This descriptive-correlational study was conducted on 200 nurses in educational-therapeutic hospitals affiliated with Tabriz University of Medical Sciences, Tabriz City, Iran, in 2021. They were recruited utilizing stratified random sampling. Data collection tools comprised a demographic questionnaire, professional autonomy questionnaire, and patient safety competency self-evaluation questionnaire. The obtained data were analyzed using descriptive statistics (frequency, percentage, and median), the Mann-Whitney U test, the Kruskal-Wallis test, the Kendall Tau, and Spearman non-parametric correlation coefficients in SPSS software, version 26. P<0.05 was considered significant.

Based on the study of the 200 nurses participating, 120 (60%) experienced a high level of professional autonomy, and 150 (75.0%) reported a moderate level of patient safety competence. There was a strong correlation between the nurses’ professional autonomy and their patient safety competence (P<0.001).

According to the findings, promotion of professional autonomy is directly related to patient safety competence in nurses, which in turn improves the quality of care.   It is recommended to adopt appropriate strategies and necessary policies by managers to improve the professional autonomy of nurses.

 This scoping review study was conducted with the aim of identifying dimensions of trust in medical care, common trust subjects, and medical trust correlates among available instruments.

 We carried out a scoping review of literature through Medline, EMBASE, Scopus, Google Scholar engine, and various information sources of grey literature, to identify eligible studies up to 2023. We merely included psychometric studies in these areas. Non-psychometrics studies were excluded. Two assessors independently and carefully chose papers and abstracted records for qualitative exploration.

 Fifty-two studies (n=37228 participants) were included in the review. The majority of the participants 67 % (24943) were adults (≥18). One-dimensionality trust was found in 36 % (19) of trust in medical care studies, while multidimensionality was identified in 64 % (33) of the studies. Ten categories of trust in medicine correlates or associates were identified. In terms of trust scales subjects, about 71 % (37) of the scales measured trust in healthcare professions, 14 % (7) health care systems, and the rest were about emergency department, trauma care emergency department, health care team, technology, authorities, telemedicine, insurer, COVID-19 prevention policies, performance, and general trust.

 Various tools have been developed and validated in the field of trust in healthcare, and several domains have been identified. Trust in medicine is correlated by a variety of factors such as patient characteristics, healthcare provider factors, healthcare organization features, health conditions, and social influences. It is suggested that researchers pay more attention to the most commonly known dimensions in preparing tools.

It is crucial for medical personnel to be aware of cancer symptoms and engage in appropriate screening practices. This study aimed to investigate the knowledge of Iranian healthcare staff regarding cancer warning symptoms, their attitudes towards cancer risk factors, and their willingness to undertake cancer screening tests. This cross-sectional study involved administering validated questionnaires to 145 medical staff. In addition to descriptive statistics, independent sample t-test and Analysis of Variance (ANOVA) were utilized to compare knowledge, attitudes, and performance of cancer screening tests. Pearson's correlation coefficient was used to determine the relationship between demographic and occupational variables and participants' knowledge and attitudes regarding cancer risk factors and screening practices. The mean knowledge and attitude scores were 7.97 ± 2.01 and 35.41 ± 4.69, respectively. Among the 125 female participants aged 25-57 years, only 44% performed monthly breast self-examinations, 22.1% sought specialist physicians for breast cancer screening, and only 20.51% of female participants over the age of 40 underwent mammography. Regarding cervical cancer screening, 27.2% had undergone annual Pap smear tests, and 17.6% referred to a specialist for annual pelvic examinations. Among staff older than 45 years (24 participants), only one had undertaken an occult blood test and colonoscopy for colorectal cancer screening. Although most healthcare workers demonstrated awareness of cancer warning signs, they did not engage in regular preventive screening practices. Regular educational programs should be implemented to encourage healthcare personnel to perform routine cancer screening.

Self-directed learning (SDL) as an effective strategy in surgical technology students can significantly help to improve their skills and clinical competence. The present study aimed to determine SDL ability and its relationship with Perceived Perioperative Competence in senior undergraduate surgical technology students.

 Materials & Methods:

The present descriptive study was conducted based on a cross-sectional design. This research included 207 final-year surgical technology students via the census method. Data collection tools included a demographic characteristics form, the Self-Directed Learning Instrument (SDLI) developed by Su-Fen Cheng (2010), and the Perceived Perioperative Competence scale. After collecting the data, they were analyzed in SPSS version software (version 20).

The mean SDL and clinical competence scores were reported as 73.8±8.9(intermediate level) and 107.2±17.3 (intermediate level), respectively. Among various dimensions of perceived clinical competence, interaction with colleagues had the highest value (3.4±0.6). Among the dimensions of SDL, interpersonal communication obtained the highest value (3.8±0.4). To investigate the relationship between SDL and clinical competence, Kendall's Tau and Spearman's correlation coefficients were obtained at 0.601 and 0.794, respectively, pointing to the significant positive relationship between the two variables (P<0.001).

As evidenced by the obtained results, the SDL ability predicts the clinical competence of surgical technology students; therefore, revising the curricula of surgical technology students at the BS level and paying attention to the principle of student-centeredness in the education process, along with conducting training courses on SDL principles, can improve students' clinical competence.

 Considering the importance of physician-nurse relationship in emergency departments and its role in improving the quality of services, patient satisfaction, job success and staff satisfaction, this study was conducted to investigate nurses' attitude about the professional doctor-nurse relationship and career success of the nurses in emergency departments.

 This study is a descriptive study in which 197 nurses working in the emergency departments of hospitals affiliated to Tabriz University of Medical Sciences participated. Data collection tools included demographic characteristic; physician-nurse professional communication questionnaire and nurses' career success questionnaire. The collected data were analyzed using descriptive and inferential statistical tests with SPSS ver.21 statistical software.

  The findings showed that the mean (SD) of the professional physician-nurse relationship from the perspective of participating nurses was 3.07 (0.54). Cooperating dimension with the mean score of 3.34 (0.79) had the highest score and imposing opinions and tasks dimension with the mean score of 2.62 (0.85) had the lowest score. Also, the mean (SD) score of nurses’ career success was 4.21 (0.40) with the highest mean in the dimension of system assistant 4.33 (0.55) and the lowest mean in the effective dimension 4.08 (0.41).

Considering the importance of the professional physician-nurse relationship, it is necessary to pay more attention to the effective factors in its promotion by implementing interventions such as professional communication skills training and effective interaction in strengthening the professional relationship of the treatment team.

Practical Implications: 

 The results of this study can be used to improve professional communication between health care team members and their work success. As a result, in addition to increasing job satisfaction and improving the psychological condition of personnel, the safety of patients will also be increased and the amount of injuries caused by communication defects will be decreased.

Reflection is considered an essential element in nurses’ practice with different positive outcomes, we decided to determine the level of nurses’ reflection and then assess the relationship between nurses’ reflection with their self-efficacy and work engagement.

In this cross-sectional study, a total of 240 nurses were selected from seven educational hospitals affiliated with Tabriz University of medical sciences (Iran). The stratified random sampling method was used to select the participants from hospitals. Data were collected through three questionnaires including Groningen Reflection Ability Scale (GRAS), Sherer’s General Self-Efficacy Scale (SGSES), and Utrecht Work Engagement Scale (UWES). Data were analyzed using SPSS version 13.

According to the results, the mean (SD) score of nurses’ reflection was calculated as 86.51 (8.17) out of 115. The mean (SD) score of nurses’ self-efficacy was 60.89 (11.11) out of 85. Moreover, the mean (SD) total score of nurses’ work engagement in a possible range of 0 to 6 was 3.39 (1.36). There was a positive and significant relationship between the total reflection score with work engagement and self-efficacy scores.

According to the results, nurses working in different units showed different scores of reflection. Moreover, the results of the present study showed that nurses’ reflection is associated with nurses’ work engagement and self-efficacy. Therefore, nurse managers and nurse educators should improve nurses’ skills in reflection and they should support the reflective practice in clinical settings.

The knowledge and attitude of nurses are among the main factors in the application of the nursing process and its implementation in the patient care. Thus, this study was conducted to investigate the knowledge and attitude of nurses regarding the nursing process in the emergency departments (8 centers) of Tabriz University of Medical Sciences.

This descriptive research was conducted in the Emergency Departments of Medical and Educational centers of Tabriz University of Medical Sciences. Two hundred and sixty-three emergency nurses were included in the study. Sampling was done by census method and nurses completed the electronic questionnaire of knowledge and attitude toward the nursing process. Finally, the data was analyzed using SPSS v22.

 The results show that the overall mean score of attitude toward the nursing process is 50.33, and the overall mean score of awareness towards the nursing process is 24.19; both of them are at the average range. Also, the results show a statistically significant relationship between the nurses' age and the nurses' experience with their knowledge (p=0.016).

According to the results of the study, it can be concluded that although the nurses' level of knowledge and attitude about the nursing process was average, they accepted the nursing process as a care framework. Investigating the items of the questionnaire showed that the nursing process implementation is time-consuming and also is mainly written. Therefore, it is possible to empower and encourage nurses to use the nursing process quickly by using the necessary training and eliminating unnecessary tasks.

The high mortality and morbidity rate of COVID-19 turned this pandemic into the most challenging health issue. Here we systematically reviewed the consequences of COVID-19 in heart transplant recipients.

The terms “Coronavirus” or “COVID19”, “SARS-CoV-2”, “Heart Transplantation”, and “Cardiac Graft” were searched focusing on heart transplant patients with positive severe acute respiratory syndrome of coronavirus-2 (SARS-CoV-2) on June 22, 2022, in Web of Science / ISI, PubMed and Ovid ProQuest, Scopus.

The results showed that of 14 eligible studies that were included in the systematic review, 8 were case reports, and 6 case series. Among 109 reported cases, 67 patients were male and 22 were female and about the rest, it was not reported. The minimum hospitalization day was one day and the maximum was 60 days. In three case reports, the studied patients died, and in one case series, 7 out of 28 patients died. The most reported symptoms were shortness of breath (85.7%), cough (76.2%), and myalgia/fatigue (76.2%), followed by rhinitis (66.7%) and fever (7.7%). 66 percent).

Although the symptoms of the disease in these patients are similar to other patients, the mortality rate is high. Considering that the studies conducted on heart transplant recipients with covid-19 have mostly been in the form of case studies, it is suggested that larger studies be conducted so that more accurate information can be obtained regarding the survival rate, symptoms of the disease, and the type of drugs used.

Practical Implications:

 The mortality rate of heart transplant cases affected by COVID-19 was 23.6% (21 patients).In four studies the duration of hospitalization was not mentioned, but the others varied from no hospitalization in one case to up to 60 days. The most reported symptoms were dyspnea (85.7%), cough (76.2%), and myalgia/fatigue (76.2%), followed by rhinitis (66.7%) and fever (66.7%). Treatment differed for each patient, but hydroxychloroquine, antibiotic therapy including Azithromycin, and lopinavir/ritonavir were the most commonly used drugs.

Background:

 The high mortality and morbidity rate of COVID-19 turned this pandemic into the most challenging health issue. Here we systematically reviewed the consequences of COVID-19 in heart transplant recipients.

Methods:

 The terms “Coronavirus” or “COVID19”, “SARS-CoV-2”, “Heart Transplantation”, and “Cardiac Graft” were searched focusing on heart transplant patients with positive severe acute respiratory syndrome of coronavirus-2 (SARS-CoV-2) on June 22, 2022, in Web of Science / ISI, PubMed and Ovid ProQuest, Scopus.

Results:

 The results showed that of 14 eligible studies that were included in the systematic review, 8 were case reports, and 6 case series. Among 109 reported cases, 67 patients were male and 22 were female and about the rest, it was not reported. The minimum hospitalization day was one day and the maximum was 60 days. In three case reports, the studied patients died, and in one case series, 7 out of 28 patients died. The most reported symptoms were shortness of breath (85.7%), cough (76.2%), and myalgia/fatigue (76.2%), followed by rhinitis (66.7%) and fever (7.7%). 66 percent).

Conclusion: 

Although the symptoms of the disease in these patients are similar to other patients, the mortality rate is high. Considering that the studies conducted on heart transplant recipients with covid-19 have mostly been in the form of case studies, it is suggested that larger studies be conducted so that more accurate information can be obtained regarding the survival rate, symptoms of the disease, and the type of drugs used.

Practical Implications:

 The mortality rate of heart transplant cases affected by COVID-19 was 23.6% (21 patients).In four studies the duration of hospitalization was not mentioned, but the others varied from no hospitalization in one case to up to 60 days. The most reported symptoms were dyspnea (85.7%), cough (76.2%), and myalgia/fatigue (76.2%), followed by rhinitis (66.7%) and fever (66.7%). Treatment differed for each patient, but hydroxychloroquine, antibiotic therapy including Azithromycin, and lopinavir/ritonavir were the most commonly used drugs.

Career anchor identifies job-related values ​​and capabilities. Eight career anchors are: Functional- Technical, General Managerial, Autonomy & Independence, Security & Stability, Creativity & innovation, Serve & Dedication, Pure Challenge, and Lifestyle anchor. Each person has a special career anchor. Knowing the career anchors of employees is important both for the individuals themselves and for the managers of the organization. Adapting the career anchor to the nurse's work leads to improved work outcomes.

Methods & Materials:

This is a correlational study. Data collection tools included background characteristics, job satisfaction and job anchors questionnaire which consisted of eight anchors of Functional- Technical, General Managerial, Autonomy & Independence, Security & Stability, Creativity & innovation, Serve & Dedication, Pure Challenge, and Lifestyle. After obtaining the ethical approve, the link of electronic questionnaires was provided to all nurses working in the hospitals of East Azerbaijan University of Medical Sciences (about 4000 nurses). Inclusion criteria were having at least a bachelor's degree and employment as a clinical nurse and exclusion criteria were not completing more than 10% of the items by the respondents. Data were analyzed in SPSS 16 by descriptive, analytical and regression tests.

Findings:

 Data from 470 nurses were analyzed. The mean and standard deviation of the participants' age and work experience were 35.97±7.29 and 12.16±6.90, respectively. According to the results, the most dominant career anchors were the anchors of lifestyle, serve & dedication, and security and stability, respectively. The lowest scores were related to the Creativity & innovation anchor and the General Managerial anchor. The job satisfaction score was also in the middle range (12.99±14.46 from the range of 15 to 75). Job satisfaction scores were also moderate. After adjusting the confounders, the relationship between job satisfaction score and anchors of lifestyle, general management, functional- technical and autonomy & independence was significant.

 According to the findings, adjusting work shifts and stabilizing employment positions are recommended to increase job satisfaction and align the career anchor with the nursing job.

Although several studies have highlighted the beneficial effects of Aloe vera on burn wounds, limited clinical evidence exists in this regard. This study aimed to evaluate the impact of the Aloe vera gel on healing, itching and pain of burn patients.

This clinical trial was conducted at Sina Hospital in Tabriz, Iran. The patients with second and first degree burn wounds on symmetrical organs, were randomly assigned to control (n=34) and experimental (n=34) groups. The Aloe vera gel and silver sulfadiazine cream were used in the experimental and control groups, respectively. To assess the healing effects, the Bates-Jensen Wound Assessment Tool (BWAT) was employed. Regarding itching and pain, visual analogue scale (VAS) was used for precise evaluation and comparison on days 1, 3, 5, 7, 9 and 14. The data were analyzed using SPSS version 13.

Although the wounds in both groups healed up completely within two weeks, the healing process among the patients in the experimental group was faster. The peak of wound itching was on day 7 in both groups. The wound itching significantly reduced half an hour after being dressed with Aloe vera gel. The wound pain in the experimental group was less than control group during the study period. Moreover, there was no pain in either experimental or control group on day 14.

Aloe vera is an effective agent in reducing itching and pain, and it can substantially increase the rate of healing. Accordingly, this agent can be considered in the treatment of burn wounds.

One of the concepts that has been recently emphasized in the care of chronic diseases such as chronic kidney disease (CKD) is the activity of patient in his/her health management, which is called patient activation. Knowing the level of patient activation can help physicians and nurses implementing high quality care and proper patient education. The aim of this study was to evaluate the patients' activation and the factors affecting it in patients undergoing hemodialysis.

In this cross-sectional study, a total of 180 patients undergoing hemodialysis were selected from the largest hemodialysis center in Iran by simple random sampling. Data collection was performed using demographic information and patient activation measure (PAM). Data were analyzed by SPSS software ver. 26 using ANOVA, t-test, and Pearson correlation coefficient tests.

The results showed that the mean activation score for hemodialysis patients was 56.25±16.77 and most of them were in level 1 of activation. The analysis showed that the mean activation score was statistically significant in terms of marital status, place of living, educational level, history of kidney transplantation, income, and age of the patients (P values were under 0.05 for all).

In general, the activation rate of hemodialysis patients was moderate and a limited number of samples were in level 4 of patient activation. Therefore, it is suggested that the activation level of patients should be assessed in early stages of diagnosis of CKD, and then the patients' care should be provided in accordance with the activation level of individuals and based on person-centered approaches.

Since the outbreak of COVID-19, various treatments have been frequently reported for patients infected with this virus, especially in transplant patients/recipients.

Investigating of kidney transplant patients under immunosuppressive therapy infected with COVID-19 can pave the way to understanding, handling, and treatment of COVID-19.

We had a brief review of the literature on immunosuppressive therapy in kidney transplants infected with COVID-19. This was based on the PubMed Database with keywords “kidney, transplant, COVID-19, and immunosuppress” after hospitalization of kidney transplantation infected with COVID-19. He had already been recorded in the Organ Transplant Registry (ID≠ 64510) of Tabriz University of Medical Sciences /Iran.

We reported the clinical course of a 45-year-old man with a history of kidney transplantation and immunotherapy who was infected with COVID-19 with respiratory infections and positive RT-PCR (Real-time polymerase chain reaction). He was treated with hydroxychloroquine, Kaletra, CellCept, and prednisolone for 5 days, and finally discharged from the hospital. In addition, reviewing of 47 papers with 851 samples showed that immunosuppressant medications alone could be a therapeutic choice in kidney transplants infected with COVID-19 with careful management.

Patients with organ transplantation infected with COVID-19 may show different clinical signs, clinical course, and prognosis due to underlying diseases and the use of immunosuppressant medications. It might be best to continue taking the immunosuppressant medications but modify them based on the patients' conditions such as clinical symptoms, laboratory results, paraclinical examinations.

 While organ transplantation is a common surgical procedure worldwide, it is yet well-examined how the recipients of newly-transplanted organs adapt and accept a new organ from another body. Adaptation and acceptance of a vital organ from another person is a complex phenomenon, and medical staff needs to delve into this issue to provide appropriate care.

 The present study aimed to explore the transplant recipients' experiences of adaptation to the transplanted organ.

 A qualitative research design with a hermeneutic phenomenological approach was adopted in this study. In-depth unstructured interviews were conducted by one of the authors (Z. S.) in different locations across Iran. The purposive sampling method was used to select 20 transplant recipients (n = 4 kidney transplantation; n = 10 heart transplantation; n = 4 liver transplantations; and n= 2 blood transfusion).

 The constitutive pattern emerged from the data was ‘Psychological adaptation to transplanted organ’, with three themes (namely ‘Alien organ,’ ‘Ensure of being the patch of togetherness,’ and ‘Durability of new organ in body’) and several sub-themes.

 According to the organ recipients' experiences, it takes time for the recipients to accept another person's organ as their own. The transplant team members need to openly and proactively discuss the many psychological and spiritual issues to which the newly-transplanted organ recipients are exposed to facilitate the adaptation and acceptance of the new organs.

In the outbreak of infectious diseases, non-pharmacological intervention might be the only available protection tools. The aim of this systematic review is to investigate whether it is or is not necessary to wear masks in new corona virus (COVID-19) outbreaks in the community.

On February, 28, 2020, related databases were searched with the following keywords: "COVID-19"; "COVID 19"; 2019-nCoV; 2019-CoV; coronavirus; mask* and facemask. We updated the search in March 13, 2020. A total of 982 relevant reports were identified after removing duplicates. Of these, 71 references were screened based on titles and abstracts. After excluding unrelated studies, 36 studies were included in the full-text review and were assessed for eligibility. Finally, 3 articles met our inclusion criteria.

In three wards of hospital with more exposure to infected patients, wearing the N95 respirator while using regular disinfectants and hand hygiene, was a better way to prevent COVID-19 transmission from patients to nurses and physicians when compared to non-users of masks. Another study on family members with a history of travelling to Wuhan, showed that those who had worn a surgical mask only during the hospital visit, were infected. However, the 7 years old child of the family who wore a surgical mask, was not found to be infected by COVID-19. Finally, none of eleven healthcare workers who had unprotected exposure with confirmed cases were infected.

Due to the newness of the COVID-19 virus, no clinical trials have been found regarding the use of the masks in the prevention of the disease, and the level of evidence were low.

Studies show that some of the factors such as pain and psychological changes could decrease the quality of life of patients with cancer. The understanding of these factors can enhance the effectiveness and process of cancer treatment. Therefore this study was conducted to investigate the quality of life in women with cancer and its influencing factors. This was a cross-sectional study which was carried out in the city of Tabriz in the northwestern part of Iran in 2016. The sample consisted of 150 women diagnosed with cancer. The EORTC QLQ-C30 (version 3) was used for evaluating the quality of life of the women. The collected data were analyzed in the SPSS ver. 13 using descriptive and inferential statistics. Also, t-test and ANOVA test were applied to investigate the correlation between the dimensions of quality of life and socio-demographic variables. P < 0.05 denoted as statistically significant. The results showed that the quality of life in the function and symptoms dimensions were in acceptable levels. In the function dimension, the highest and lowest scores belonged to the cognitive and emotional domains, respectively. Also, those women who had the symptoms of insomnia and fatigue, and reported the pressure due to financial burden of cancer treatment had a significantly lower quality of life. A low score was reported in general health dimension. No statistically significant relationships were reported between the socio-demographic characteristics and the women’s quality of life and its dimensions. Since sleeplessness and fatigue reduce the quality of life in women with cancer, nursing interventions are required to relieve cancer-related symptoms. The financial burden of cancer treatment is high. Therefore, governmental and insurance agencies should help with the costs paid by the patients and prevent from reducing their quality of life.

The evaluation of service quality is a key measurement which provides the necessary information for effective decision making and providing high quality care. This study aimed to investigate the factors affecting the service quality gap for the provision of care from the perspective of surgical patients hospitalized in a teaching hospital in the Northwest of Iran in 2015.
In this descriptive cross-sectional study a total of 300 patients and 101 nurses were selected by random sampling method. The data regarding patients’ expectations and perceptions of the quality of healthcare services were collected using the SERVQUAL questionnaire. Also, the nurses’ demographic data were assessed using the demographic data tool.
The mean and standard deviation of the patients’ expectations and perceptions of the quality of healthcare services were 66.59)8.52) and 51.81(11.97), respectively. In all dimensions of the quality of healthcare services, the patients’ perceptions were lower than their expectations. The greatest gap was observed in the dimensions of assurance and responsibility and the lowest gap was reported in the domains of reliability and empathy. There were statistically significant relationships between the nurses’ age, work experiences in surgical wards, professional experiences of nurses, patients’ income level and the gap in the quality of healthcare services.
Despite great efforts directed at the field, the healthcare system still faces numerous challenges in the provision of high quality healthcare services to the patients. The health system should support low-income people and employ professional and experienced nurses for improving the quality of healthcare services.

This study investigated quality of healthcare services from patients’ perspectives and its relationship with patient safety culture and nurse-physician professional communication.
A cross-sectional study was conducted among 300 surgery patients and 101 nurses caring them in a public hospital in Tabriz–Iran. Data were collected using the service quality measurement scale (SERVQUAL), hospital survey on patient safety culture (HSOPSC) and nurse physician professional communication questionnaire.
The highest and lowest mean (±SD) scores of the patients’ perception on the healthcare services quality belonged to the assurance 13.92 (±3.55) and empathy 6.78 (±1.88) domains,respectively. With regard to the patient safety culture, the mean percentage of positive answers ranged from 45.87% for "non-punitive response to errors" to 68.21% for "organizational continuous learning" domains. The highest and lowest mean (±SD) scores for the nurse physician professional communication were obtained for "cooperation" 3.44 (±0.35) and "non participative decision-making" 2.84 (±0.34) domains, respectively. The "frequency of reported errors by healthcare professionals" (B=-4.20, 95% CI = -7.14 to -1.27, P Organizational culture in dealing with medical error should be changed to non punitive response. Change in safety culture towards reporting of errors, effective communication and teamwork between healthcare professionals are recommended.

The spiritual dimension of health has an important role in human health, well-being and quality of life. The aim of this study was to determine the spiritual health of nursing and surgery room students studying in Larestan University of Medical Sciences in 2015.
This study was a cross-sectional study, in which 221 nursing and surgery room students studying in Larestan University of Medical Sciences were recruited to study by census. Data were collected with use of Palutzian and Ellison questionnaire of spiritual well-being. Ethically, Participants verbal consent was obtained and anonymously and confidentiality of the data was assured to them. SPSS software ver.16 were used for data analysis.
The mean score of spiritual health (79/6±58/81) was at a moderate level. The mean scores of the religious health and existential health were 51/3±65/34 and 98/3±93/46, respectively. 23.07% of students had low spiritual health, 75.11% had moderate spiritual health and 8.1% had high levels of spiritual health. There was significant relationship between mean score of spiritual health and sex; and males had lower spiritual health. The relationship between spiritual health with other demographic characteristics such as age, course of education, residency and marital status were not significant.
The findings indicate on addressing students’ spiritual health. Incorporating of the issue of spirituality in the context of theoretical and practical courses of medical sciences, education, and promote religious agents patterns to improve spiritual health in universities, is recommended.

The anesthesiology BSc program was first started in 2008 in Iran and has been continued so far. The purpose of this study was to provide a critical appraisal of the anesthesiology BSc program according to the Eisner’s Connoisseurship and Criticism Model.
This qualitative study employed Eisner’s Connoisseurship and Criticism Model to evaluate the anesthesiology BSc program. Consistent with this model, the curriculum and educational environment of the program were assessed in three main dimensions: description, interpretation and evaluation. Data were gathered by means of observation, interview and review of the literature. Results were then discussed and criticized by professors and PhD students of Tabriz School of Nursing and Midwifery.
While other countries offer anesthesiology as nursing MSc program, it is offered as anesthesiology BSc program in Iran. Preliminary codes extracted from interviews were summarized in four themes: inattention to context, uncertainty, lack of differentiation between educational levels, and educational irregularities. Findings also indicate shortages in educational space and facilities for students and faculty members. Hourly-paid instructors who teach students during their work shifts are employed for clinical training.
It seems that due to the novelty of the program and the importance of caring for anesthetized patients, a comprehensive evaluation of the program and making the necessary changes are essential. It also should be determined whether the program has been successful to achieve its ultimate goal that is improving the quality and quantity of care for patients; final decision then should be made about the continuation or termination of the program.

Simulation is a teaching strategy from behavioural approaches, that used in the natural and humanistic systems, and includes activities imitate from actual environment, and this approach has some benefits and challenges. The purpose of this study, hence, was to investigate the concept, applicant, benefits and challenges of simulation approach in the nursing education. This study was a review article for which we searched the Medline, CINAHL, SID databases as well as Google search by using the key words, such as education, nursing and simulation. Then, the retrieved results were limited to English and Persian language and studies during 2002 to 2013; 50 books, articles and web sites were categorized and assessed. Initially, simulation concept was explained, and, afterwards, simulation types and stages were introduced. Then, requirements of simulation in nursing education and its challenges facing the use of this approach were reviewed. Results indicated that this approach was effective in generating attraction among student and this approach also increased the student's satisfaction and their self-confidence. It seems that, by considering the benefits of this approach, using of simulation will help increase in nursing education; although, the challenges of this approach should be considered in orders to increase the efficacy of this approach.

Contemporary advances in technology and sciences parallel to changeable patient's status make it essential to nurses to combine their skills and knowledge with evidences in order to identify patient's problems, care planning, implementation and evaluation through interaction with other health team members. Nurses must be able to make clinical decisions independently which is possible just by using research evidences in clinical practice. The purpose of this article is concept of evidence based nursing and teaching barriers and facilitators in nursing. This article is an integrative review. Different data bases such as ProQuest, Ovid, PubMed, Science Direct, Google Scholare magiran, sid were applied for collecting articles by using evidence based teaching, evidence based nursing and education as key words. At all 24 articles have been included in this review. Studies show many barriers in implementation of EBN and teaching it to students. For example professors do not have enough time to teach EBN or do not know how to teach it. Furthermore nurses have information and time shortages and workload that make it hard to work based on evidences. It seems that by making national policies and making EBN compulsory, universities and professors will teach EBN to nursing students.

Admission to an intensive care unit is recognized as an extremely stressful experience for both patients and their families. Also the responses of nurses to visitors in ICU unit are different. Because of the problems that visitors cause for patients and unit managing they limit visits. At present, family visiting policy at intensive care units contains more limitations. The aim of this study was to analyze the effect of open ICU visiting on nurses and family's beliefs about nursing care. A semi-experimental study was designed. Because of the opposition to changing visiting policy at wide level, sample was contained 14 employed nurses at intensive care unit from Sina hospital in Tabriz, from 2007 to 2008, which each completed one researcher-structured questionnaire. Questionnaire was developed by using likert scale with 28 questions about personal and social factors of nurse's beliefs about changing visiting policy from restricted to open and its validity and reliability was calculated. Results showed that before changing in visiting policy nurse's beliefs was negative (78/6). Based on maximum score= 4 mean of scores was 76.71±6.31 and after open visiting was 79.64±5.94. Difference between scores distribution of nurse's beliefs before and after changing visiting policy was meaningful by using Wilcoxon test (P= 0.038). And correlation between nurse's beliefs and social factors was not meaningful (r= 0.053, P= 0.85). According to study findings, predominant factors in nurse's beliefs were social factors, specially: colleague's believes, supervisors roles, unit managers and policies.